Best Practice Case Studies-Sickle Cell Exercise Associated Collapse

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Sickle cell trait (SCT) involves a mutation in one of the hemoglobin genes, causing red blood cells to potentially sickle under low oxygen conditions. While significantly less severe than sickle cell disease, SCT can still pose risks, particularly for athletes. Symptoms such as muscle weakness, pain, and collapse during intense exercise may occur, known as Exercise Collapse Associated with Sickle Cell Trait (ECAST). ECAST is critical as the risk of death is up to 40 times higher for athletes with SCT compared to those without.<br /><br />Certain conditions heighten the risk of ECAST, including intense exercise, inadequate rest, high altitude, dehydration, and excessive heat. Athletes experiencing ECAST might present with symptoms like muscle weakness, tenderness, rapid breathing, and slightly elevated temperatures, differing them from conditions like heat stroke or cardiac issues.<br /><br />All collapsed athletes require immediate medical evaluation to check pulses, breathing, mental status, and muscle strength. If ECAST is suspected, swift transport to a hospital for IV fluids and electrolyte monitoring is crucial to prevent destructive rhabdomyolysis—a potentially deadly condition.<br /><br />Preventing ECAST involves identifying athletes with SCT via blood tests, promoting year-round conditioning, ensuring gradual increase in exercise intensity, adequate rest, proper hydration, and acclimation to temperature and altitude where training occurs.<br /><br />After an ECAST incident, athletes should undergo testing for SCT and other potential conditions. A medical review of possible risk factors is recommended, as is educating athletes about ECAST symptoms and preventive measures. Return to play should be gradual, without symptoms at rest, normal lab values, and under a doctor’s supervision.<br /><br />The American Medical Society for Sports Medicine (AMSSM) provides resources and guidance for athletes, helping ensure their health and safe participation in sports.

Meta Tag

Edition 2nd Edition

Related Case 2nd Edition, CASE 20

Topic Hematology

Keywords

2nd Edition, CASE 20

2nd Edition

Hematology

Sickle Cell Trait

ECAST

athletes

exercise

rhabdomyolysis

hydration

high altitude

muscle weakness

prevention

AMSSM